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Georgia rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $5,623.41 / $9,549.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $4,365.16 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,071.52 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,168.69 / $6,918.31